Creating a new smile with your own hands: direct resin veneers

I. Introduction

People´s awareness of esthetic dentistry is no more under discussion; it´s a fact. Ordinary men and women, not only media stars, want radiant smiles. Esthetic enhancement of dentition can be done through a great array of procedures and different degrees of invasiveness.

Which is the best procedure? The expert practitioner is able to determine which is the best solution through an accurate diagnosis. Generally speaking, patients prefer the less invasive treatments although some of them imply that the work will need to be redone some time in the future.

“We all know that everything we do in dentistry has a lifespan and at some point most, if not all, of the restorations we place will need to be replaced.” (1)

Direct bonding of composite resin can provide excellent and extremely conservative esthetic results. For decades, direct resin veneers have been an important part of the services provided by cosmetic dentists, but the results are now better because of the improvements in many areas. For example, the incorporation of a variety of new shades makes it possible to create virtually life-like restorations. To be able to simulate the teeth structure in all their characteristics, of course, does not depend only upon the quality of the material or the equipment. The dentist´s hands and his of her artistic sensibility and skills play an irreplaceable role.

Although we now have the tools to create beautiful restorations with our own hands, some practitioners hesitate to recommend direct composite veneers because they don´t feel sure about their artistic eye, have not developed the skills needed to perform such an artistic work or have acquired a dependence on laboratories that they find difficult to brake. This must not prevent them to inform the patient about all the alternatives. Of course, directly bonded composite veneers are not a magical solution for every case. In fact, “too many dentists are utilizing veneers instead of orthodontics”(2).

The main advantages of directly bonded composite veneers are, little or no tooth preparations, easy to repair intraorally should it chip or fracture, and reversibility. Another advantage is that “Composite resin will not cause iatrogenic wear of opposing structures”. (3) The disadvantage is that they may not prove to be as durable as some indirect alternatives.

Direct resins have been called “the flagship of cosmetic dentistry” (4). To enhance or rehabilitate a smile using directly sculpted and polished composite resins is one of the most challenging treatments. It requires an exceptionally high level of skill, a great deal of concentration, and full control over the results.

For these and many other reasons I believe composite resin should be included in the menu of services provided by a cosmetic dentist who strives to conquer excellence in this field.